筋膜囊下浸润麻醉与内眼手术

Subtenon' s Infiltration Anesthesia for Intraocular Surgery

目的:评价筋膜下浸润麻醉在内眼手术中的效果。方法:对白内障囊外摘出联合后房型人工晶体植入术14眼,白内障抽吸联合后房型人工晶体植入术5眼,抗青光眼周边虹膜切除术2眼,小梁切除术3眼,视网膜硅胶垫压术后取出硅胶带1眼,共25眼,作筋膜下浸润麻醉,方法是:在结膜囊内滴0.5％Dicain表面麻醉后,在角膜缘结膜作切口,用冲洗针头沿巩膜表面伸入10～15mm,向1O:00时及2:00时方位各注射0.75％布比卡因和2％利多卡因混合液1.5～2ml。结果:麻醉效果为:Ⅰ级20眼(80％)Ⅱ级4眼(16％)Ⅲ级1眼(4％)。结论:这种麻醉方法应用于内眼手术,其麻醉效果好,安全,简便。特别适合于独眼,晚期青光眼及年老体弱心功能不全的患者。眼科学报 1999;15:265-266.

Purpose:To study the efficiency of Subtenon's anesthesia for intraocular surgery Methods: Subtenon' s infiltration anesthesia was performed in the following ocular surgeries: Extracapsular cataract extraction combined with intraocular lens(IOL) implantation (14 eyes), cataract aspiration with IOL implantation(5 eyes), iridectomy(2 eyes), trabeculetomy(3 eyes), and removal of silicon band after scleral buckle for retinal detachment (1 eye) . After superficial anesthesia with 0. 5% Dicaine solution and incision of limbal conjunctira were performed, a 22 gauge blunt connected with a 5 ml syringe containing a mixture of 2% lidocain and 0. 75% of Bupivacaine was introduced posteriorly a-long with the surface of the sclera towards both 10:00 and 2:00 o'clock direction, under Tehon's capsule at tabout 10 - 15mm away from the limbus. A slow injection of 1. 5 -2.0ml of the anesthesia was made at the equator of the globe. Results: According to the standard made by Pang chenjiu, the efficiency of anesthesia was as follows: Grade I: 20 eyes(80% ), Grade II: 4 eyes (16% ) , Grade III : 1 eye (4% ) . Conclusion: It is an effective, safe and simple anesthetic method for intraocular surgery especially for those with single eye, glaucoma eye in absolute stage and old patient with insufficient heart function. Eye Science 1999; 15: 265 - 266.